Are you Male or Female?
What is your height?
What is your current weight?
Please list the diets you have tried and whether or not they were successful:
What is your weight loss goal?
How long have you been struggling with this problem?
Do you have any medical conditions?(Please list:)
Are you taking any medications?
Are you pregnant or nursing?
What are your "food weaknesses"?
Describe a routine day for you, to me:
Are you SERIOUS about losing weight?
How much would you be willing to pay for a serious weight loss program?